| Doctor Name: | CLIFFORD L. SUSSMAN |
| NPI Number: | 1033115688 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A45906 |
| Business Practice Address: | 150 W. Foothill Blvd San Dimas, CA - 917731102 |
| Business Phone Number: | 9095999921 |
| Business Fax Number: | 9095923147 |
| Mailing Address: | 150 W. Foothill Blvd, SAN DIMAS |
| State: | CA |
| Postal Code: | 917731102 |
| Phone Number: | 9095999921 |
| Fax Number: | 9095923147 |
| NPI Enumeration Date: | 06/27/2005 |
| NPI Last Update Date: | 12/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/17/2006 |
| NPI Reactivation Date: | 04/05/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | A45906 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |